8 days old

Manager Clinical Pharmacist - Ohio Telecommute - 910354

Columbus, OH 43215 Work Remotely
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  • Job Code
    910354

As one of the largest pharmacy benefits managers in the United States, UnitedHealth Group provides a professional culture where you're empowered and encouraged to exceed the expectations of our members, with better schedules than retail and more reach than any hospital. Join us and start doing your life's best work.(sm)

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At OptumRx, a part of the UnitedHealth Group family of businesses and one of the largest pharmacy benefits managers in the United States, we're dispensing with tradition. Join us as we take on the challenge of reinventing the health system.

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The Clinical Pharmacist, Quality is responsible for engaging our network providers and local pharmacies in discussions related to Part D quality measures and programs primarily for our Medicare and Retirement business. Performance management is tracked by designated provider metrics, inclusive minimally of 4 STAR gap closure and improved quality. The person in this role is expected to work directly with our clinical quality team, providers and pharmacies to build relationships, ensure effective education and share reporting specifically focused on Part D measures.They will proactively identify performance improvement opportunities through data analysis and discussion with subject matter experts; and influence provider behavior to achieve needed results.

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This position is a home-based telecommuting role; however, candidates must be based in Ohioto be considered.

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If you are located in Ohio, you will have the flexibility to telecommute* as you take on some tough challenges.

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Primary Responsibilities:

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  • Functioning independently, travel across assigned states to meet with providers to discuss Optum and UHC tools and programs focused on improving the quality of care for Medicare Advantage Members specifically focusing on medication adherence and high-risk medications
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  • Strategize with our Optum and United HealthCare quality team in the development of training and analytical materials for Stars and HEDIS, with a primary focus of medication adherence
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  • Engage and collaborate with pharmacies; including the independent pharmacies across the state, to improve medication adherence of Medicare Advantage Members
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  • Establish positive, long-term, consultative relationships with physicians, medical groups, IPAs and ACOs
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  • Develop comprehensive, provider-specific plans to increase their HEDIS and Part D performance and improve their outcomes
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  • Participate in Clinic days to address members with multiple gaps and perform medication reconciliations
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  • Provide ongoing strategic recommendations, training and coaching to provider groups and pharmacies on program implementation and barrier resolution
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  • Act as lead to pull necessary internal resources together in order to provide appropriate, effective provider education, coaching and consultation; training will include Stars measures (HEDIS/CAHPS/HOS/med adherence), Optum program administration, and use of plan tools, reports and systems
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  • Provide reporting to health plan leadership on progress of overall performance of pharmacy measures, gap closure, and use of virtual administrative resource
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  • Facilitate/lead monthly or quarterly meetings, as required by plan leader, including report and material preparation
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  • Provide suggestions and feedback to Optum and health plan
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  • Provide clinical knowledge to our providers of chronic disease states in particular diabetes, hypertension and hyperlipidemia and changes in pharmacy practice in adult and geriatric patient populations to serve as an authoritative information source on drugs and their utilization in therapy
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  • Deliver high quality evidence-based therapeutic recommendations to providers
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  • Work collaboratively with health plan market leads to make providers aware of Plan-sponsored initiatives designed to assist and empower members in closing gaps
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  • Role includes up to 50% travel
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Youll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

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Required Qualifications:

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  • BS in Pharmacy or PharmD
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  • Current, unrestricted Pharmacist license in Ohio
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  • 3+ years of experience working as a Licensed Pharmacist
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  • 3+ years of Pharmacist experience within a health plan or managed care
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  • 3+ years of direct experience working to close quality measurement gaps and strong working knowledge of clinical standards of care, preventive health, and Stars measures
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  • 1+ year of Medicare experience
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  • Proficiency with Microsoft Word, Excel, Outlook and PowerPoint
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  • Ability to travel up to 50%
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  • Stars or HEDIS experience
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  • If you need to enter a work site for any reason, you will be required to screen for symptoms using the ProtectWell mobile app, Interactive Voice Response (i.e., entering your symptoms via phone system) or similar UnitedHealth Group-approved symptom screener. When in a UnitedHealth Group building, employees are required to wear a mask in common areas. In addition, employees must comply with any state and local masking orders
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Preferred Qualifications:

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  • Pharm D degree
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  • Provider, client and/or member-facing experience
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  • MTM experience with Outcomes and or Mirixa platforms
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  • Experience working with network and provider relations/contracting
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  • Experience with electronic medical record systems
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  • Consulting experience
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  • Data analytics experience
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Careers with OptumRx. We're one of the largest and most innovative pharmacy benefits managers in the US, serving more than 12 million people nationwide. Here youll fill far more than prescriptions. As a member of one of our pharmacy teams, youre empowered to be your best and do whatever it takes to help each customer. You'll find unrivaled support and training as well as a wealth of growth and development opportunities driven by your performance and limited only by your imagination. Join us. There's no better place to help people live healthier lives while doing your life's best work.(sm)

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*All Telecommuters will be required to adhere to UnitedHealth Groups Telecommuter Policy

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Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.

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UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.

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Job Keywords: Pharmacist, RX, Pharm D, Pharmacy, Ohio, Telecommute, Remote, Travel

Posted: 2021-02-18 Expires: 2021-03-20

UnitedHealth Group is the most diversified health care company in the United States and a leader worldwide in helping people live healthier lives and helping to make the health system work better for everyone.

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Manager Clinical Pharmacist - Ohio Telecommute - 910354

UnitedHealth Group
Columbus, OH 43215

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